Tissue connector apparatus and methods

Abstract

A tissue connector assembly comprising a clip movable between an open configuration and a closed configuration and a mechanical restraining device attached to the clip for restraining the clip in its open configuration. A needle may be releasably attached to the clip. A method for connecting tissues is also disclosed. The method includes inserting a clip through tissue with the clip being biased in an open position by a restraining device secured to the clip, and removing the restraining device from the clip.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS[0001]This application is a continuation of U.S. patent application Ser. No. 09 / 090,305, entitled Tissue Connector Apparatus and Methods and filed Jun. 3, 1998, now U.S. Pat. No. 6,641,593, which application is incorporated by reference in its entirety and to which priority is claimed under 35 U.S.C. §120.FIELD OF THE INVENTION[0002]The present invention relates to instruments and methods for connecting body tissues, or body tissue to prostheses.BACKGROUND OF THE INVENTION[0003]Minimally invasive surgery has allowed physicians to carry out many surgical procedures with less pain and disability than conventional, open surgery. In performing minimally invasive surgery, the surgeon makes a number of small incisions through the body wall to obtain access to the tissues requiring treatment. Typically, a trocar, which is a pointed, piercing device, is delivered into the body with a cannula. After the trocar pierces the abdominal or thoracic wall, it ...

AI Technical Summary

Benefits of technology

[0014]According to another aspect of the present invention, a tissue connector assembly generally comprises a clip having a spiral shaped configuration when in a closed configuration and an open configuration wherein the clip is configured to form less than a full 360 degree turn. The spiral may be formed in one plane or may extend from a plane of a first loop of the spiral to form a generally conical shaped helical clip. The spiral shaped configuration of the clip generally provides for tight compression of the connecting tissue and may reduce the amount of surface area of the clip exposed to blood flow in an anastomosis, for example.

[0015]A needle may be attached to the clip for piercing tissue / graft material, and may be releasably attached to facilitate removal of the needle after insertion of the clip. The clip is generally small enough to prevent obstruction of a surgeon's view of the tissue being connected and allow for precise control of the clip by the surgeon.

[0018]Another aspect of the present invention generally includes inserting a needle and a clip attached to the needle through tissue with an instrument, with the ability to remove the needle from the clip with the same instrument. The present invention may allow a surgeon to single handedly insert and close the clip to connect tissue using a minimum amount of instruments.

Problems solved by technology

Constructing an arterial anastomosis is technically challenging for a surgeon in open surgical procedures, and is almost a technical impossibility using minimally invasive techniques.

Many factors contribute to the difficulty of performing arterial replacement or bypass grafting.

If one of the tissues is affixed too close to its edge, the suture can rip through the tissue and impair both the tissue and the anastomosis.

Another factor is that, even after the tissues are properly aligned, it is difficult and time consuming to pass the needle through the tissues, form the knot in the suture material, and ensure that the suture material does not become tangled.

These difficulties are exacerbated by the small size of the artery and graft.

Another factor contributing to the difficulty of such procedures is the limited time available to complete the procedure.

The time the surgeon has to complete an arterial replacement or bypass graft is limited because there is no blood flowing through the artery while the procedure is being done.

If blood flow is not promptly restored, sometimes in as little as thirty minutes, the tissue the artery supplies may experience significant damage, or even death (tissue necrosis).

In addition, arterial replacement or bypass grafting is made more difficult by the need to accurately place and space many sutures to achieve a permanent hemostatic seal.

The difficulty of suturing a graft to an artery using minimally invasive surgical techniques has effectively prevented the safe use of this technology in both peripheral vascular and cardiovascular surgical procedures.

When manipulating instruments through cannulas, it is extremely difficult to position tissues in their proper alignment with respect to each other, pass a needle through the tissues, form a knot in the suture material once the tissues are aligned, and prevent the suture material from becoming tangled.

Therefore, although there have been isolated reports of vascular anastomoses being formed by minimally invasive surgery, no system has been provided for wide-spread surgical use which would allow such procedures to be performed safely within the prescribed time limits.

It is extremely difficult to perform such positioning techniques in minimally invasive procedures.

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